Provider Demographics
NPI:1528169398
Name:TSENG, GEORGE LUNGCHEN (DPM)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:LUNGCHEN
Last Name:TSENG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1510 S CENTRAL AVE
Mailing Address - Street 2:120
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204
Mailing Address - Country:US
Mailing Address - Phone:818-242-3668
Mailing Address - Fax:818-242-2425
Practice Address - Street 1:1510 S CENTRAL AVE
Practice Address - Street 2:120
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204
Practice Address - Country:US
Practice Address - Phone:818-242-3668
Practice Address - Fax:818-242-2425
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4580213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T16346Medicare UPIN
CA5450150001Medicare NSC
CAE4580Medicare PIN